Causes of bleeding between menstruation or postmenopausal - diagnosis and treatment


Every woman throughout life has a certain allocation. Some are considered the norm, and some pathology. That is why we will help you understand a bit and determine if you need to consult a doctor. Since we are talking about bloody discharge, first of all you should pay attention to: color, character, volume, phase of the menstrual cycle.

For women, it is important to assess the following points:

  • color of discharge: scarlet, burgundy, brown, etc.,
  • nature of discharge: only blood, mucus bloody streaks,
  • volume of discharge: much more than usual, not significantly, etc.
  • bleeding occurs in the first or second phase of the cycle,
  • track overall well-being: fever, malaise, etc.

To establish the correct diagnosis and the correct prescription of treatment, this information is necessary.

Spotting girls

In girls, menstruation on average begins at the age of 10-14 years. Until this period, it is also called puberty, normally there should not be any vaginal secretions. Until puberty in an adolescent body, an egg cell does not mature, female sex hormones are secreted in very small quantities. That is why there is no menstrual flow.

If a girl, under the age of 9 years, has spotting, you should immediately consult a doctor.

This period of time from birth to the beginning of puberty is called physiological rest. That is why, if suddenly you notice any bleeding from your child, even in a small amount, then you should immediately contact a pediatric gynecologist. These secretions may be the cause of diseases such as:

  • inflammatory processes of the genitourinary system,
  • replenishment of the digestive tract,
  • pathology of puberty.

Spotting girls

Consider spotting girls aged 14-19 years. At the beginning of puberty, when the first periods come, then the menstrual cycle does not always become regular at once.

Menstrual flow can come in 1-2 months or several times a month. So the menstrual cycle can be restored, at this time the organism is rebuilt and for this it needs a little time. Regeneration of the regular menstrual cycle takes from three months to a year. And this is considered the norm. But this process must be monitored.

If you see that the menstrual flow is abundant, while the girl is in great pain, then you should consult a doctor. All adolescent gynecologists recommend immediately after the appearance of the first menstruation see a doctor. After the regular menstrual cycle has normalized, any bleeding that does not occur in its phase is a pathology.

If all the same you see bloody discharge, then the reason for this may be:

  • hormonal imbalance,
  • stresses
  • infectious diseases,
  • malnutrition, for example, lack of vitamins in the body.

How to recognize the bleeding pathological nature? These are small, spotting in addition to menstruation. Spotting does not end after menstruation, more than 8 days. At the same time, there can be a general deterioration of the condition (dizziness, nausea, pale skin, etc.).

All manifestations of these symptoms should urgently contact a gynecologist. In order for the doctor to prescribe in time drug therapy. Otherwise, if you ignore a visit to the gynecologist with these symptoms, it can lead to infertility or to profuse blood loss.

Discharge in women of reproductive age

Every healthy woman of reproductive age in the normal once a month there is bloody discharge, which is called menstruation (monthly). During menstruation, endometrium is rejected (uterine mucosa), which is accompanied by bleeding. In the normal selection of dark red in color, there are also clots.

Normally, the appearance of scanty, smearing discharge a couple of days before the onset of menstruation is considered.

Menstruation should not be during pregnancy.

Normally, it is also considered when, after the first sexual intercourse, discharge appears with blood. This is due to the rupture of the virgin pleura. But these allocations are short-lived and usually pass the next day.

Pathology signals

But there may also be bleeding that signals the presence of pathology. Such secretions include:

  • spotting after sex,
  • bleeding that occurred either before menstruation or after,
  • intermittent spotting that is not associated with the use of hormonal agents, the use of a spiral,
  • discharge (heavy, abundant) after the onset of menopause, and the monthly were already absent for more than six months.

Cause of uterine secretions

Allocations are divided into uterine and intermenstrual. The cause of uterine secretions can serve such diseases as:

  • hormonal imbalance,
  • endometritis,
  • endometriosis,
  • uterine fibroids,
  • polyps
  • infectious diseases of the pelvic organs,
  • neoplasms
  • ectopic pregnancy,
  • cervical erosion,
  • cervical cancer.

Causes of discharge between menstruation

The reasons may be:

  • failure of the endocrine system,
  • blood disease
  • diseases of the cardiovascular system - hypertension,
  • use of the uterine helix, taking contraceptives,
  • SPT infection
  • reproductive trauma,
  • polycystic ovaries,
  • emergency hormonal drugs.

Traumatic injury

If during intercourse any objects were used that could violate the integrity of the tissues or damage could be caused by aggressive actions. In cases with minor injuries - stitches. If the injury is severe, it can go to the removal of the reproductive organs.

Appearance of a tumor

Discharge may occur if a woman has polyps of the cervix or the body of the uterus. And also not excluded and malignant tumors - cancer. As the size of the tumor increases, the intensity of such secretions increases. In this case, if you suspect something, you need to consult a doctor and get tested. Make an ultrasound or tomography, biopsy suspicious areas.

Bleeding during pregnancy

When a woman just got pregnant, the woman's body has not yet fully rebuilt. That is why the following norms are considered the norm:

  • yellowish discharge - the body's response to restructuring,
  • small discharge in which there is a little blood - is considered normal, as this is the reason for the embryo to attach.

But remember that any bleeding during pregnancy is a reason to immediately consult a doctor. All bleeding, especially in the first trimester, can be a threat to the fetus.

Causes of discharge can be:

  • minimal placental abruption,
  • sexually transmitted infections
  • brown secretions may occur at the time when you started your period,
  • the risk of miscarriage
  • improper presentation of the fetus.

All discharge, which is accompanied by blood at the initial gestational age, basically means a greater threat to the fetus. Based on this, if you notice any discharge in which there is blood, then immediately go to the doctor. And it is better to go to the hospital for maintenance therapy and preservation of the fetus.

The discharge that appears in the later periods speak of the threat of premature delivery and placental abruption. For these reasons, a woman’s emergency hospitalization is needed during this period. And wait for a doctor is not necessary, it is necessary to urgently call an ambulance.

Discharge through miscarriage

Any bleeding during pregnancy implies a miscarriage. But this does not mean that if you have bleeding, you will lose the child. The most important thing is the nature of the discharge.

At the very beginning of the pathological process of isolation scanty and brown. As the process grows, the volume of discharge increases accordingly and the color changes to brighter (scarlet). Low back pain appears, general condition worsens, weakness appears. That is why during the correctly rendered medical care in 60% of cases the pregnancy can be maintained. Since if there is already profuse bleeding, the fetus can no longer be saved.

Postpartum discharge

Childbirth is a fairly complex and difficult process for the body. That is why in order for the body to fully recover, it needs time. After natural childbirth or by caesarean section, bloody discharge occurs. This scares many women. But in fact this is the norm.

Immediately after the birth itself, the excretions are rather abundant, red or dark red. After a couple of hours, the discharge becomes moderate, but the end is not over. The amount of discharge gradually decreases, depending on how quickly the milk arrives. The discharge usually lasts for 6-8 weeks after delivery. This is all considered normal.

Pathological secretions are those that do not decrease during the week, but on the contrary increase. Or, on the contrary, a sharp cessation of bleeding is considered pathology.

Discharge after examination by a gynecologist

Usually, after a visit to the gynecologist, there is no bleeding. In rare cases, you may notice a small daub after inspection on a gynecological chair. The reason for this is usually mechanical damage to the mucosa (gynecological speculum). Also, after taking a smear from the cervix, cervical canal. Since the contents are scraped from the mucous membrane, the vessels are damaged.

It happens that women have very weak and fragile vessels, this is what can cause small discharges even after a routine examination by a gynecologist without the use of medical instruments. Normally, the discharge is brown, not abundant, which disappears the next day after the examination. Otherwise, if the discharge does not cease, then you should consult a doctor.

Discharge after abortion

After such a procedure as an abortion, the body needs time to recover. Normally, after an abortion (regardless of the type of abortion) copious discharge. They are brown and abundant in nature. On the second day, the discharge looks like during the usual menstruation, the duration of such discharge is usually 10-12 days. It is also the norm that blood clots are observed in the secretions. Abnormality after abortion is usually considered a pathology. Or incessant copious discharge is also an alarming signal and requires urgent medical attention.

Discharge after intercourse

Normally, after intercourse, there is no discharge with blood admixture. If they are still there, this is definitely a signal to consult a doctor. The reason for the appearance of bloody discharge (of a spotty or abundant nature) may be:

  • mechanical damage (rape, violent sex, sex using sex toys),
  • trauma to the arch of the uterus or vaginal walls,
  • inflammatory processes of the pelvic organs (vaginitis, bacterial infections),
  • sexually transmitted infections
  • polyps
  • erosion.

Discharge with contraceptive use

When a woman decided to use birth control pills, it is considered normal that discharge can occur within 1-3 months. Allocation usually smearing character that occur before menstruation, and after it. If the discharge with an admixture of blood begins to intensify and is no longer smearing in nature, but rather resembles not abundant periods, then most likely the pills are chosen incorrectly. In this case, you need to urgently go to the doctor.

Causes of bleeding during menopause

Normally, if you have already started menopause and your period does not come already - this is the norm. But if you notice a discharge that has an admixture of blood, even the most insignificant, then this is a reason to immediately consult a doctor. Since any discharge that contains blood after menopause is considered a pathology and can be serious. There are two types of discharge after menopause.

  • Spotting in the premenopausal period. This usually occurs at the age of 45-50 years. The nature of such discharge: smearing, maroon-red color, duration from 2 days to a week. Occur in case of failure of the ovaries, failure of the thyroid gland, liver.
  • Postmenopausal bleeding. Age of women after fifty years. It is during this period that any discharge with an admixture of blood is considered the most dangerous.

Causes of bleeding can be:

  • endometriosis,
  • uterine fibroids,
  • cervical erosion,
  • polyps in the uterus,
  • oncology (cervical cancer, cancer of the uterus),
  • inflammatory processes (cervitis, vulvovaginitis, etc.),
  • sexually transmitted infections.

Diagnosis and treatment of bleeding

The treatment of any pathological secretions is strictly individual. Before you assign the correct treatment, you must pass the diagnosis, find the cause. Basically they use conservative methods (selection of medicines, restorative therapy). If necessary, apply operational methods.

Self-medicating is very dangerous. This can lead to irreversible consequences.

Diagnosis includes:

  • history of women (the full story of how it all began, complaints, etc.),
  • gynecological examination on the chair with taking all the necessary tests (smears),
  • if necessary, take a biopsy,
  • ultrasound diagnosis of the pelvic organs,
  • general tests (blood, urine, hormone tests).

The sooner a woman turns to her gynecologist, the sooner the problem can be solved, avoiding rather unpleasant health situations.

What is spotting

Normally, clear or white mucus is secreted from the vagina. Its color and texture depend on the phase of the menstrual cycle. Discharge with blood impurities indicates that the vaginal mucosa or uterine wall has been damaged. The appearance of bloody clots immediately before the menstrual period or during the formation of the cycle after childbirth is considered normal.

Various violations of the menstrual cycle can lead to bloody clots in mucus. If the bleeding is accompanied by pain, you should immediately consult a doctor. They may be one of the signs of endometriosis. Estrogen supplements often cause premature endometrial rejection, resulting in blood clots. Problems in the thyroid gland, adrenal glands can affect the process of ovulation and cause premature monthly bleeding. There are the following main causes of the appearance of bloody clots:

  • Acceptance of hormonal drugs. After taking the pills there is no pain, scanty discharge.
  • Inflammatory diseases of the reproductive system. Depending on the type of ailment, pulling or sharp pains, fever, nausea, weakness may appear.
  • Genital infections. The discharge has a characteristic unpleasant odor. Accompanied by minor pain, itching, burning.
  • Uterine fibroids, polyps. In the initial stages of the disease, bleeding appears in the middle of the cycle. By the end of menstruation, they temporarily stop. If the disease is not treated, they become permanent.
  • Ectopic pregnancy. The condition is accompanied by pain in the lower abdomen of varying intensity. A woman experiences strong weakness. State of faintness.
  • Endometritis. Pains aching lower abdomen. In the chronic form of the disease, the temperature rises.
  • Cervical erosion. Often proceeds covertly without any pronounced symptoms. Blood appears during sex.

Mid-cycle spotting

Before the onset of ovulation, mucus should not contain any blood clots. Brown discharge with blood in the middle of the cycle suggests that the woman has cervical erosion. They may have a characteristic odor. An accurate diagnosis will be able to be examined by a gynecologist. Intermenstrual discharge in adolescents and women who have recently given birth are considered normal. This indicates that the body is trying to normalize the cycle.

In the second half of the cycle

A couple of days before menstruation, blood-streaked discharge may appear. They will be scarce, but will begin to increase as the release of the egg and the separation of the upper layer of the endometrium. If the discharge with an unpleasant odor, then the likelihood of cervical pathology is high. One of the reasons for the appearance of blood in the second half of the cycle is the lack of progesterone. Endometrium exfoliates ahead of time, therefore bloody clots appear.

There are no monthly, but there is blood discharge.

After conception, women may appear pink discharge. It is necessary to immediately consult a doctor, because the smear begins with the threat of abortion. Some women experience heavy brown-bleeding. They are a sign of ovarian depletion.Under normal physical well-being, pinkish hues are indicative of the following deviations:

  • inflammation of the uterus,
  • hormonal imbalance,
  • spiral incompatibility
  • the presence of a tumor
  • thyroid problems
  • the presence of intrauterine cysts.

After intrauterine interventions

Bloody secretion may occur after installing the intrauterine device (IUD). Normally, they should be scanty without an unpleasant smell. If after the installation of the IUD started heavy bleeding, accompanied by pain, you should consult a doctor. The infection was probably carried during the procedure. Light bleeding after an abortion is considered normal. Fully mucous after curettage of the uterus will recover in about a week, then the discharge with blood will disappear.

Discharge after taking the drugs

Vodosa from the vagina appears in 75% of women during the period of adaptation of the organism to combined oral contraceptives. The amount of sex hormones varies, so a scarlet color can appear in the transparent mucus. A similar situation is observed after taking emergency contraception drugs. Some antibiotics cause severe dysbiosis that violates the vaginal microflora. It leads to an exacerbation of chronic diseases and bleeding. Vaginal discharge with blood clots can occur when taking the following drugs:

Mucous discharge with streaks of blood during pregnancy

With the first 2-3 weeks of pregnancy, the body has not had time to adapt to a new state. During this period, bloody clots of pinkish color may appear. If blood appears at 5 or 11 weeks, then there is a high probability of placental abruption and abortion. The woman is referred for an ultrasound and is being tested for hormones. When the embryo is rejected, the secretion of bloody secretion is accompanied by pain in the lower abdomen, which resembles contractions.

Bloody vaginal discharge as a sign of pathology

An important factor in determining the risk of the appearance of such discharge is their quantity and connection with the woman's menstrual cycle.

Copious bloody discharge
If a woman has an abundant bleeding that is not related to the physiological menstrual cycle, this is a sign of a serious pathology. Such a patient should be examined as soon as possible by the gynecologist. This symptom is potentially life-threatening for a woman, and the loss of time can have serious consequences for women's health.

Brown spotting, and in some cases even black, is a consequence of the destruction of blood cells in the uterus. It is necessary to determine the cause of bleeding as soon as possible.

Scanty and spotting
If bleeding that is not associated with the menstrual cycle is scarce, then they may indicate the following pathologies:

  • menstrual disorders,
  • the presence of endometriosis,
  • severe cervical erosion
  • cervical cancer,
  • infectious lesion (with systematic spotting bleeding, whether or not associated with the days of the menstrual cycle, and having a fetid odor).

Communication of bleeding from the menstrual cycle

Bleeding before and after menstruation
Spotting after menstruation and in front of them - a fairly common phenomenon. In her life, almost every woman has ever noticed an unexpected vaginal bleeding.

It should be remembered that the scarlet bloody discharge, which gradually become more abundant, is considered the norm on the first day of menstruation.

Brown dark spotting before menstruation indicates the presence of a pathological process in the uterus: endometriosis, polyp, endometrial hyperplasia (proliferation), etc. Pink discharge of diluted blood with an unpleasant smell before menstruation and after them - a symptom of chronic endometritis or chronic endocervicitis.

Abundant and prolonged bleeding after menstruation and before them are most often dysfunctional. They need to be stopped, and then find out and begin to treat the causes of their appearance. They occur due to impaired hormonal function of the ovaries. It is in these organs that the oocytes cyclically ripen and female sex hormones are produced, which are involved in the observance of the normal menstrual cycle.

The causes of bleeding after menstruation and in front of them can be:

  • hormonal disorders in the body in various diseases and stress,
  • endocrine pathologies, most often - a small amount of thyroid hormones,
  • stopping or starting hormonal contraceptives,
  • use of emergency contraception drugs: Postinor, Ginepriston, etc.,
  • the use of certain drugs, as well as the initiation or cessation of the use of supplements containing estrogen.

Spotting in the middle of the menstrual cycle

Experts say that intermenstrual scanty bloody discharge from the vagina - a phenomenon that carries no danger. It is caused by hormonal fluctuations associated with the onset of ovulation. Spotting between menstruation occurs in almost 30% of women.

Normal discharge in the period of ovulation are characterized by the following features:

  • small total volume (spotting),
  • duration - no more than 72 hours,
  • the mucous consistency of scarlet, pinkish or brown,
  • no need to use feminine hygiene products,
  • the examination does not identify other causes of bleeding from the genitals.

Often unexpected bleeding from the genital tract, even in small quantities, can also be a sign of gynecological diseases.

Bleeding between periods usually begins on the 10th – 16th day, counting from the first day of the last menstruation, that is, from the beginning of the cycle. Normally, they look like poorly noticeable mucous discharge with streaks of blood, which last from half a day to three days. If over time the bleeding becomes stronger, or does not stop for more than three days, you should definitely contact a gynecologist.

The doctor must stop the bleeding and prescribe the necessary examinations. But even if such bleeding stopped independently, it is still worth an examination by a gynecologist and performing an ultrasound of the pelvic organs. Such a phenomenon may be the only symptom of the presence of a hidden gynecological disease.

Causes and treatment of bleeding in the middle of the cycle
The most common cause of uterine bleeding between menstruation in a healthy woman is the sudden sharp fluctuations in the level of estrogen in the body. During ovulation, the level of this hormone increases rapidly. And since it affects the lining of the uterus, a similar symptom appears. Spotting during or after ovulation is considered the physiological norm, if during a medical examination they show no signs of other diseases. However, they are subject to medical correction. For the treatment and prevention of such hormonal surges, women are usually recommended to avoid stressful situations and to prescribe herbal remedies.

A bloody brown discharge, pink or dark, in the middle of the menstrual cycle occurs when:

  • the release of the egg from the follicle at the time of ovulation,
  • the presence of intrauterine device,
  • taking hormonal contraceptives
  • the use of some other drugs that affect the menstrual cycle,
  • carrying out gynecological procedures, for example, cauterization or conization of the cervix,
  • low functional activity of the thyroid gland,
  • polyposis, endometriosis, cervical erosion, chronic inflammation of the uterus (endometritis),
  • miscarriages
  • genital infections (eg, gonorrhea),
  • genital injuries,
  • fibromas and other genital tumors.

Bleeding during menstruation
Of course, bleeding is an essential element of menstruation. However, in some cases, a change in the consistency of the discharge can be a sign of pathology.

So, if bleeding instead of menstruation acquires the character of large clots, this may indicate:

  • pathological bend of the cervix,
  • violation of blood clotting and tendency to thrombosis,
  • vitamin B deficiency,
  • pathological processes in the uterus (myoma, polyp, endometriosis).

Bloody up to menses, after them and in the middle of the cycle, require special attention and thorough examination, which should include:
  • consultation of the gynecologist,
  • bacteriological and microscopic analysis of secretions,
  • colposcopy
  • Ultrasound of the pelvic organs.

Spotting with miscarriage

A bleeding from the genitals during pregnancy is the most common symptom of threatening miscarriage. At the same time, accompanying the discharge, or preceding their appearance, may be back pain and pulling pain in the lower abdomen.

It must be remembered that if suddenly a woman had a bloody discharge from the vagina, and she was diagnosed with "threatened miscarriage", then this does not mean that the pregnancy will be interrupted in any case. Most women, despite the presence of bleeding in the early or late periods, with timely and adequate treatment successfully end the pregnancy and give birth to healthy children.

Spotting after childbirth

Normal discharge after childbirth (the so-called lochia) is pink in color and resembles diluted blood or blood. These are postpartum physiological secretions from the uterus, which include blood, mucus and rejected nonviable tissues of the decidual membrane of the uterus.

Most often, the duration of the allocation of such lohii is from 3 to 6, occasionally up to 8 weeks after birth. A necessary sign of the normal course of this process is a tendency to reduce the number and clarification of discharge. Lochia in the first week resembles the usual periods, only more abundant and sometimes containing blood clots. Every day their number should decrease.

Gradually, lochia acquire a yellowish-white hue due to an increase in the amount of mucus, they begin to resemble egg white, but still may contain small blood impurities. At about the 4th week after birth, only scanty, “spotting” discharges should be observed. By the end of 6-8 weeks after birth, vaginal discharge should have the same character and amount as before pregnancy.

Spotting after being examined by a gynecologist

The appearance of scanty bleeding after a gynecological examination is not uncommon, and should not cause much concern. During the examination, microtraumas of blood vessels and minor damage to mucous membranes are not excluded. Often, such discharge occurs when the doctor uses a mirror when examining, or takes a smear. Smearing occurs from the vaginal mucosa, urethra and uterine cervical canal. Simply put, mucosal cells simply scrape off the wall of the vagina or other organ. Naturally, damaged tissue may bleed for a while.

The main thing to remember is that bleeding should stop as soon as possible. In any case, the woman will be useful to trace their condition. If the discharge of blood does not stop, or itching, burning, or pain sensation joins it, you should immediately contact a gynecologist, describing all the details.

Value of discharge

For a woman it is important to evaluate not only the fact of discharge with blood from the genital tract, but also the following points:

  • color of discharge (scarlet, burgundy and others),
  • character (proper blood or mostly mucus with bloody streaks)
  • the amount of discharge (is a normal daily wipe enough?)
  • what phase of the cycle is bleeding occurring
  • there are other signs of ill health (fever, weakness, etc.).

All this information is necessary to establish the correct diagnosis and to plan an adequate treatment. Among the most common possible situations in which there are blood discharge from the genital tract, should be highlighted:

  • hormonal disorders,
  • inflammatory processes
  • Neoplastic changes of benign and malignant nature,
  • injuries of various kinds
  • pregnancy and postpartum,
  • menopause and postmenopausal period,
  • use of contraceptives.

In each case, therapeutic and diagnostic tactics have fundamental differences. Only a specialist (obstetrician-gynecologist) can say for sure because of what there can be certain spotting that needs to be done, or on the contrary, it should not be done categorically. Independent attempts at treatment can lead to deterioration up to profuse uterine bleeding.

Juvenile bleeding

In adolescent girls, a fairly heavy discharge with blood can occur as a result of a stressful situation, malnutrition, a sharp change in the content of female sex hormones. Consultation of the pediatric gynecologist is necessary, since abundant vaginal discharge leads to the development of anemia and severe systemic changes. In most cases, quite certain changes in lifestyle and nutrition.

Discharge before menstruation

Often, women of reproductive age notice small mucous discharge with streaks of blood a few days before the onset of menstrual bleeding. Gradually, the intensity of discharge increases, the actual menstruation begins. This can be regarded as an individual feature, the result of the use of oral contraceptives or the installation of an intrauterine device. No special examination and treatment is required.

You need to contact a specialist for an internal gynecological examination and other methods, if the duration and amount of such discharge increases with each month, there are other signs of ill health. Perhaps the causes of bleeding in this case is a tumor process or endometriosis.

Mid cycle bleeding

The mid-cycle discharge is usually not large, widespread in women of reproductive age. This is the so-called ovulatory bleeding, caused, of course, by ovulation and subsequent changes in hormonal levels. No special examination or therapeutic intervention is required in this case.

Changes in menstruation

Any woman knows the normal duration of menstrual bleeding: within 4-7 days. If the bleeding continues to go more than this time period, you should think about possible diseases, namely:

  • pathology of the ovaries or uterus,
  • systemic endocrine diseases
  • tumor processes.

In all the above-mentioned cases, the diagnosis is based on the study of the hormonal profile of the woman, the results of a gynecological examination. Treatment will depend on the cause of the bleeding. Self-treatment in such a situation is extremely dangerous, since excessive uterine bleeding without emergency medical care can lead to the death of the patient.

Inflammatory diseases

When inflammatory changes, both acute and chronic, there are certain changes in the structure of the mucous membrane of the reproductive sphere (destruction). As a result, the woman notes a clear discharge with visible streaks of blood. Usually other signs of inflammation come to the fore, as the bleeding is not abundant and short. For example, classic cheesy discharge at thrush is so plentiful that a woman simply does not pay attention to the admixture of blood.

Treatment depends on the duration of the inflammatory process and its localization. Diagnostics may include a variety of instrumental and laboratory methods.

Neoplastic processes

Polypops of the cervix and the body of the uterus are the most common among benign processes, and cancer is the most common among malignant processes. The bleeding from women with the appearance of a tumor is due to the proliferation of pathological tissue, its introduction into the tissue is still healthy, followed by destruction.

Typically, the intensity of such secretions increases with the growth of the tumor. For diagnostic purposes, in addition to the internal gynecological examination, are shown:

  • Ultrasound of the pelvic organs,
  • tomography,
  • hysterosalpingography,
  • biopsy of suspicious lesions.

Therapeutic tactics are determined by the nature of the tumor process. With a benign variant, excision or ablation of the pathological focus is performed. For malignant neoplasms - removal of all organs of the reproductive sphere, followed by radiotherapy and chemotherapy.


Spotting during pregnancy, mucous with streaks of blood on any period of gestation is a sign of serious danger. Даже незначительные по объему выделения с прожилками крови – один из ранних признаков самопроизвольного прерывания беременности или отслоения плаценты (во 2-3 триместре беременности). Особенно опасны алые выделения, так как это признак недавно начавшегося кровотечения из артериального сосуда.

The main thing that a woman should do in such a situation is to immediately contact a medical institution (maternity hospital or surgical hospital). Any obstetric hemorrhage is an emergency condition requiring the provision of qualified specialist assistance. In no case can you figure out for yourself why there is spotting, after identifying it, you need to urgently consult a doctor, as the time for emergency intervention by medical personnel may not remain.

The diagnostic value in such a situation has an ultrasound, as the least traumatic for the patient. Depending on the degree of developmental disorders of the fetus and placenta, further treatment may be conservative and operative (abortion or emergency delivery).

Postpartum period

Spotting after a physiological birth or abortion made in a medical institution is a completely natural phenomenon. This is due to the violation of the integrity of the uterine mucosa after the release of the fetus with membranes and placenta.

The intervention of a specialist is only necessary if the intensity of the discharge increases, that is, postpartum uterine hypotonic bleeding develops. In some cases, it can be stopped with aminocaproic acid and similar drugs. At worst - surgery is required and the uterus is removed.


Spotting while taking contraceptive drugs - a phenomenon quite natural and fairly common. The selection of a small amount of blood due to the fact that hormonal compounds that contains a contraceptive, can provoke the rejection of part of the uterine mucosa. No special examination and subsequent treatment is required, since such a plan of excretion disappear spontaneously.

Menopause and postmenopausal period

The bloody discharge from the vagina in a woman in menopause, especially recurring, is a reason to consult an obstetrician-gynecologist. Perhaps this is just the result of atrophic processes in the uterus. However, this may be a sign of the neoplastic processes of the reproductive organs. Tactics of treatment will be determined by the results of gynecological examination and biopsy.

Vaginal bleeding - norm or pathology?

It is considered normal in gynecology to discharge blood from the vagina a few days before the onset of menstruation; at first, the discharge is very scarce, but gradually develops into heavy menstrual bleeding. Bleeding from the genital tract can be observed for several days after the end of menstruation. Such phenomena are considered normal and do not require the help of a gynecologist.

The appearance of brown or black bloody discharge is a signal for the destruction of red blood cells in the uterus. The cause of this condition can be inflammatory and infectious diseases of the uterus and its appendages. To prevent the development of complications, a woman should consult a doctor as soon as possible.

The appearance of scant bloody bleeding from the genital tract, not associated with the beginning or end of menstruation, can signal the following pathologies:

  • Cervical erosion,
  • Menstrual disorders,
  • Endometriosis,
  • Cervical cancer,
  • Cervical polyps.

With a progressive inflammatory process in the reproductive organs of a woman, bleeding from the vagina can be mixed with pus and have a fetid odor.

Bleeding in women in the middle of the menstrual cycle

One of the common causes of the appearance of bleeding in the middle of the menstrual cycle is a sharp change in the level of the hormone estrogen in the blood. The level of this hormone increases during the readiness of the egg for fertilization (ovulation). Since estrogen directly affects the mucous membrane of the uterus, the appearance of bloody bleeding during ovulation is the physiological norm, but many gynecologists still insist on the medical correction of such hormonal surges.

Scanty brown discharge from the genital tract in the middle of the menstrual cycle can occur when:

  • Installed intrauterine device,
  • Hormonal oral contraceptives,
  • Gynecological interventions (cauterization of erosion, colposcopy),
  • Chronic inflammation of the uterine lining,
  • Threatening miscarriage,
  • Tumors of the genitals.

Bleeding from women during pregnancy

The appearance of minor scanty bleeding at the time of the introduction of a fertilized egg into the uterine mucosa is considered normal. This symptom is associated with microscopic damage to small blood vessels and does not require medical intervention. Most often, the so-called implant bleeding is observed a week before the date of the proposed menstruation.

In any other case, the appearance of bleeding in a pregnant woman is a signal for an immediate appeal to a gynecologist. This applies to any period of pregnancy, regardless of the amount, nature and color of secretions. The most common causes of bleeding during pregnancy are:

  • Risk of miscarriage,
  • Partial placental abruption,
  • Placenta previa,
  • The threat of preterm birth.

Threatening bleeding usually brown in small amounts.

Important: If bloody discharge from the vagina occurs at any time during pregnancy, a woman should immediately seek medical attention!

The danger of such secretions during gestation is that they can dramatically increase, which is fraught with dire consequences for both the baby and the expectant mother. It is urgent to call an ambulance if the bleeding is accompanied by the following symptoms:

  • Dizziness,
  • Palpitations,
  • Growing weakness
  • Paleness of the skin,
  • Stomach ache,
  • Excessive perspiration.

Such symptoms may be a sign of placental abruption and the development of internal bleeding.

Regardless of the amount of bleeding during pregnancy, the expectant mother is recommended bed rest and the absence of stress and anxiety. As a rule, gynecologists insist on hospitalization, so a woman should not refuse hospital in order not to expose her child to undue risk.

Blood spotting in women in the first trimester of pregnancy

The appearance of vaginal discharge with blood in the early stages of pregnancy may indicate a threatening miscarriage. To prevent the threat of spontaneous abortion and save the life of the fetus, a woman is sent to the gynecology department of the maternity hospital. Do not neglect hospitalization, since only an experienced gynecologist can determine whether the embryo is viable and how many percent the placenta has exfoliated. Only in a hospital setting can a doctor help a pregnant woman to save a small life.

Spotting in late pregnancy

The appearance of vaginal discharge with blood in late pregnancy may be a symptom of placental abruption and requires immediate medical attention in order not to oxygenate the baby.

The appearance of bleeding after 37 weeks of pregnancy should not scare the expectant mother, most likely, the woman begins to move the mucus plug that prevents the penetration of pathological microorganisms into the uterus. The appearance of such secretions means that childbirth will come very soon - in some women in 2–48 hours, and in others in 3-4 days. However, despite the fact that the bleeding in the last weeks of pregnancy, as a rule, is not dangerous for the woman and the fetus, you need to tell the doctor about them!

Is bleeding from women after childbirth a norm or pathology?

Normally, bloody discharge from women after childbirth is pink in color, and resembles blood. In gynecology, such secretions are called lochia and may continue for a woman in labor for another 4–6 weeks from the time of delivery. On the first day the bleeding is quite bright, resembling menstrual bleeding, with an admixture of mucus, but every day they become lighter and more transparent. Gradually, postpartum discharge becomes yellowish, resembling in appearance egg white, streaked or mixed with blood. As early as 3-4 weeks after giving birth, lochia acquires a smearing character.

If lochia does not stop for more than 6 weeks, the woman should consult a gynecologist. In some cases, the postpartum period can be delayed for 8 weeks.

The reason for the immediate visit to the gynecologist is a change in the nature of the bleeding, if with an almost transparent, they again become bright red, scarlet, brown, with an unpleasant smell. The appearance of an unpleasant smell from the discharge and pain in the lower abdomen, as a rule, indicate the penetration of the pathological bacterial flora into the uterine mucosa, which causes postpartum endometritis.

Spotting women after gynecological examination

Very often, women complain that after a gynecological examination of the cervix, they developed bleeding from the genital tract. Scanty vaginal discharge with an admixture of blood is an acceptable condition after an examination on a gynecological chair. This is due to the trauma of the small blood vessels during the collection of smears or other diagnostic procedures. Do not worry, such discharge ceases within a few hours after the inspection. However, if a woman has pain in the lower abdomen, itching of the external genital organs and increased vaginal discharge, it is urgent to consult a doctor. These symptoms may indicate infection during the examination or use of untreated medical equipment by the gynecologist.

The representatives of the fair sex should be attentive to their health, so the appearance of any alarming vaginal discharge should be a reason to consult a specialist.

Normal bleeding

Bloody up to menses can be a sign of a shift in the menstrual cycle towards shortening due to various reasons. This is a completely permissible phenomenon, like spotting after menstruation, of a smearing character, especially against the background of stress or a drastic change in the situation.

There may also occasionally be discharge from ovulation, bloody, spotting or brownish. If they are short and painless - it is not dangerous. Sometimes in the presence of cervical erosion, there may be discharge after sex due to contact bleeding from injured vessels.

Pathological secretions

Spotting in the middle of the cycle is most often a sign of pathology - important signs will be the amount of discharge, the state of health when they appear and the phase of the cycle.

Spotting between menstruation can be abundant - as a type of breakthrough bleeding, this is a reason to seek immediate help. Bleeding can be brown, very dark, like clotted blood, 1-2 tsp in volume on a daily napkin. This is a reason to consult a doctor.

The discharge may be smearing, pink in color - this may be a sign of defects in the cervix.

In addition, bleeding may be a sign:

  • menstrual disorders, hormonal disruptions,
  • adenomyosis of the uterus,
  • ectopic pregnancy
  • - tumor of the cervix or the body of the uterus,
  • uterine fibroids. polyps
  • endometrial hyperplasia,
  • inflammatory processes in the endometrium.

Other causes of bleeding between periods can be problems of the thyroid gland and adrenal glands, disorders of the pituitary gland, taking oral contraceptives, the use of drugs for emergency contraception, the use of estrogen-containing supplements, sharp fluctuations in weight.

Spotting and pregnancy

During a normal pregnancy bleeding should not be.

Spotting instead of menstruation with little or no delay may be a sign of pregnancy and the emerging threat of its termination. You must pass a pregnancy test and consult a doctor.

The bleeding during pregnancy can be of varying intensity - from minor spotting to bleeding. Especially dangerous are lower abdominal pain, bleeding and malaise. This is a sign of a miscarriage. usually in such cases hospitalization is applied, duphaston is prescribed, the discharge gradually disappears.

Bleeding during pregnancy may occur in late pregnancy - this may be a sign of the threat of premature birth or placental abruption. Immediate hospitalization is required.

In the later stages of pregnancy, bloody discharge may occur after the examination due to the softening of the cervix and its slight injury.

Spotting after menstruation: reasons for going to the doctor

The cause of menstrual abnormalities, which include untimely spotting, is usually either a hormonal imbalance or diseases of the genital organs. There are cases when such secretions occur due to the physiological characteristics of the woman's body, are the norm for her. But reassuring yourself that everything is somehow formed is not worth it anyway. The consequences of violations can be quite serious, so when there is unusual discharge, it is always better to consult a gynecologist and undergo the necessary examination.

Physiological causes of the appearance of discharge from the blood after menstruation

Normal can be considered blood discharge that occurs after the end of menstruation in the following cases:

  1. If they appear in girls at the very beginning of puberty, when hormones in the body are unstable for 1-2 years. During this period, the ovaries are in the stage of maturation, therefore, hormone production and the processes of the menstrual cycle occur irregularly. This is reflected in the fact that there is a spotting after menstruation. When the formation of the ovaries gets better, then normally such secretions should stop. Their appearance is subsequently a deviation and suggests the need to visit a doctor.
  2. Similar disorders occur in women in the premenopausal period, when ovarian function is completed. However, the likelihood of hormonal disorders and the occurrence of pathologies, which are characterized by unusual leucorrhoea, are increased during this period.
  3. When using oral contraceptives. If the smearing brown impurities appear after the end of the menstrual period within 2-3 months - this is normal, but if there are blood impurities in the future, the more they become bleeding, you should consult a doctor and find another means. Spotting occurs when installing the intrauterine device. If they occur not only after menstruation, but also on other days of the cycle, they do not stop after 3 months, this indicates the wrong arrangement of the spiral in the uterus and damage to the mucous membrane. In this case, the spiral must be removed.
  4. With low blood clotting in women, menstruation is delayed, and within about a week after their termination, bleeding is resumed in the form of smearing pink discharge. The same thing happens if a woman goes in for sports intensively or she has to lift weights.
  5. There are individual features of the structure of the uterus, contributing to the formation of blood stagnation. Due to this, its discharge is delayed, which leads to the appearance of brown smearing whiter after the cessation of menstruation.
  6. Non-menstrual bleeding occurs in women with strong experiences, fatigue.
  7. A variant of the norm is the appearance in the white of a small amount of blood about 10 days after menstruation. This condition is caused by ovulation. when the follicle envelope breaks and the egg cell leaves it.

Addition: The so-called “implant bleeding” is also considered the norm, in which droplets of blood appear in the white blood at the moment of attachment of the fertilized egg to the wall of the uterus. This happens a few days before the expected onset of menstruation.

Discharge occurred after intercourse

Discharge with bloody contents may appear after intercourse. The causes of their occurrences are also divided into the norm and pathology. If the discharge is weak, there is no reason to worry. However, when reinforcing a symptom, it is worth passing a diagnosis. The reasons for the occurrence of such a state are many. So, during sexual intercourse, a woman can get a mechanical injury. Another common cause of discharge is infection.

The absolute norm is considered bleeding after defloration - 1 sexual intercourse of a woman. However, the sign is not observed at all. Blood appears in women whose hymen is sufficiently dense. Its rupture can lead to normal hemorrhage. Если плева была тонкой и имела волнообразную форму, первый половой акт не будет характеризоваться таким проявлениям.

Кровянистые выделения могут появиться в результате небольших травм механического характера. This is one of the most popular factors that provoke such symptoms. The risk of injury increases as a result of violent or rough intimate intimacy. As a result of a strong mechanical action, damage occurs to the cervix of the vaginal mucosa. Anxiety should cause heavy bleeding.

The appearance of blood after sexual intercourse can cause sexually transmitted diseases. These pathologies include:

This category includes diseases of the female genital organs. Pathological processes develop in the cervix or vagina. In this situation, discharge with an admixture of blood is observed not only after sexual intercourse, but also during it. Such a manifestation is possible even at rest.

If a woman develops internal bleeding, she experiences severe pain of a cramping character. Unpleasant feeling is concentrated in the groin, lower back, lower abdomen. Localization depends on which internal organ has been damaged. Internal bleeding develops as a result of serious injuries, the list of which includes:

Blood in the discharge when using contraceptives

If bleeding occurred in the first 2 months after the start of hormonal contraceptives, it is considered normal. There are drugs whose use can lead to vaginal secretions with blood in any phase of the menstrual cycle. This is due to the suppression of ovulation. These drugs are:

If a woman takes contraceptives such as Postinor, blood-enriched secretions can occur due to drastic changes in the body's hormonal balance. If the symptom does not disappear at 3 or 4 months of regular use of the drug, most likely it does not suit the woman. In this situation, the drug must be replaced by visiting a gynecologist and having received a preliminary consultation.

Bleeding opened during pregnancy

The appearance of minor scanty secretions is considered normal if it occurred at the time of the introduction of a fertilized egg into the uterine mucosa. The symptom appears as a result of microdamages of small blood vessels. He does not require medical assistance. Implant bleeding is usually observed a week before the expected menstruation, if before the occurrence of such a phenomenon a woman took part in unprotected intercourse.

In all other cases, bleeding during pregnancy is a signal of the development of pathology and requires immediate medical attention. The rule applies to any term of pregnancy. At the same time, the nature of the discharge, their color and quantity are not taken into account. Most often, symptoms occur due to:

  • placenta previa
  • the appearance of the threat of miscarriage,
  • the threat of preterm birth,
  • there was a partial placental abruption.

Usually a selection warning about the development of a threat to the life and health of a child and a woman is colored brown. They stand out in small quantities. The danger of symptoms is that discharge may increase dramatically. So, placental abruption and the development of internal bleeding are accompanied by:

  • heart palpitations
  • the appearance of abdominal pain,
  • growing weakness
  • excessive sweating,
  • pallor of the skin.

If a woman has the appearance of discharge with blood, it is recommended that bed rest, the absence of anxiety and stress. Usually gynecologists insist on hospitalization.

The appearance of discharge after childbirth

Postpartum discharge is considered normal. They are called lochia. Physiological secretions are pink. They resemble ichor or diluted blood. After birth, the uterus is actively cleaned. There is rejection of non-viable tissues of the decidual membrane, as well as the release of mucus and blood. Most often, discharge after childbirth lasts 3-6 weeks. Occasionally the process can take up to 8 weeks. Normal excretions tend to reduce their number and clarify discharge. So, lochia, which appear in the first week, resemble ordinary menstruation. They may even be more abundant than the monthly. Sometimes the discharge contains blood clots. Gradually, the amount of discharge is significantly reduced.

By the end of the process, the lochia becomes a yellowish white shade. This is due to the fact that they increase the amount of mucus. They look more like raw egg white. However, they may still contain blood impurities. Normally, by the end of the process there are very few of them. Approximately at 4 weeks after childbirth, discharge becomes an obscene character. They are quite scarce. By the end of 6-8 weeks vaginal secretion should be exactly the same as before the beginning of pregnancy.

Bleeding after gynecological examination

Discharges containing blood impurities may appear after a visit to the gynecologist. If they are scanty, most likely their appearance was provoked by microtrauma, obtained during diagnostic procedures or smear collection. As a result, there is damage to large vessels, which leads to the appearance of blood in the discharge. Such small bleeding stops independently. They do not require medical care.

A dangerous symptom is the addition of pain in the lower abdomen to the bleeding. About the pathology may indicate the emergence of a sense of itching, as well as an increase in the number of vaginal secretions containing blood. Symptomatology is usually associated with infection during diagnosis. The situation may arise if the survey was carried out with the help of a medical instrument that was not processed in advance. In this situation, the woman has to undergo a re-examination and treatment.

Climax and spotting

In the period of menopause and after it, the chance of developing diseases increases significantly. The appearance of blood in the secretions may signal the presence of disorders. A symptom cannot be ignored. Many women suffer from menopause. About him in the pathological course can talk if the following symptoms

  • a woman is bothered by strong and frequent tides,
  • there is an increase in blood pressure,
  • there is an occurrence of psychological disorders
  • there is a violation of metabolic processes in the body,
  • periodically there is bleeding from the genitals.

There is a perception among women that any symptoms may occur during menopause. This leads to the fact that many patients ignore the opened bleeding from the genitals. The manifestation of the pathological menopause faced by many women. According to statistics, complaints about bleeding appeared to the gynecologist refers to about 50% of patients aged 45 years and older.

Symptoms of pathological menopause most often develops due to hormonal adjustment that occurs in the human body. The symptoms are usually dysfunctional. However, sometimes they can indicate the presence in a woman's body of a tumorous tumor of a benign or malignant nature.

The occurrence of bleeding from the genitals can cause hormone therapy, prescribed to a woman after menopause. Taking progesterone can stimulate the recovery of menstrual bleeding. Such a phenomenon can be observed for 12 years. Usually, menstruation caused by taking hormonal drugs is painless and easy. Allocations are observed no more than three or four days. This is the only type of bleeding with menopause, which does not require immediate interruption of treatment. Anxiety should cause a delayed onset of menstrual bleeding, which lasts longer than expected. Too abundant discharge containing blood clots can also indicate the development of pathology.

Experts identify two types of bleeding in menopause - during menopause and during menopause. Allocation of the first situation usually occurs due to impaired production of sex hormones. This phenomenon is observed in women aged 45-50 years. It can continue until the cessation of menstruation. And at this time there is a violation of the term of ovulation, which in turn leads to a failure of cyclic changes in the thickness of the uterine mucosa.

The usual appearance of menopausal bleeding in premenopause is observed after a delayed menstruation. Sometimes a discharge of this nature may appear on the day of its occurrence or slightly earlier. They have different intensity and are observed for several weeks or months. For such discharge in the period of menopause, relapses are characteristic. They can occur within 4-5 years.

Most often, the discharge in menopause is observed in women who have impaired metabolism or there are various endocrine diseases. The appearance of bleeding can indicate a violation of the function of the thyroid and pancreas, carbohydrate metabolism, liver and fat metabolism. The situation requires the passage of diagnosis.

Allocations in the postmenopausal period almost always signal the presence of pathology. Such bleeding can signal the development of a tumor. To identify the root cause of the symptoms, you must consult a gynecologist. He will conduct a diagnostic curettage of the mucous membrane of the uterus and the cervical canal. The resulting material will be sent for histological examination.

Bleeding after abortion

Any abortion is associated with more or less extensive traumatization of uterine wall vessels. Therefore, the appearance after abortion bleeding, different in color and quantity, is almost inevitable.

In about 80% of women, after a drug exposure, a full abortion occurs within a week, and the bleeding stops completely. In 95% of women, a complete abortion occurs by the 14th day after the manipulation. A scanty serous discharge after medical abortion may occur until the next menstruation.

Monthly after medical abortion should begin approximately after such a period, the duration of which for a particular woman is a normal menstrual cycle. In addition, it is normally possible to delay them up to 10 days. Although in some cases (about 13% of patients), the first menstrual periods after medical abortion can begin only 2 months after the abortion procedure.

Abundant bleeding after an abortion is quite rare. Usually this serves as an indicator of blood coagulation disorders. It must be remembered that after an abortion uterine bleeding is considered strong if:
1. Two hygienic pads of the largest size are completely soaked with blood for an hour.
2. This continues for more than two hours in a row.

In such cases, a woman must urgently undergo a second consultation with a gynecologist and make an ultrasound. To stop uterine bleeding, the doctor may prescribe additional medications that reduce the uterus and reduce bleeding.

Regardless of the presence or absence of bleeding, a week after the abortion, it is necessary to go back to the gynecologist and undergo an ultrasound test.

Spotting after intercourse

Brown spotting, pink or dark spotting that occurs after sexual intercourse, most often have fairly safe reasons that can be easily eliminated by timely referral to a gynecologist. However, it must be remembered that if bleeding during or after sex is abundant, and accompanied by severe pain, you should seek medical help as soon as possible.

The bleeding that occurs in women after sexual intercourse is called postcoital bleeding. Consider the main reasons for their appearance.

Mechanical damage
The release of blood after sex from the genitals can be caused by physical exposure. Most often it is the trauma that a woman can get in the process of too rough or active sex:

  • injuries and tears of the walls or vaginal fornix,
  • damage to the mucous membrane of the cervix,
  • damage to the eroded cervix.

The probability of injury or rupture of the vaginal wall is especially high if pain and blood appear suddenly, right during sexual intercourse, and the bleeding is quite abundant. In such cases, you must immediately call an ambulance, as with any serious injuries that are accompanied by bleeding.

Infectious diseases
Often the cause of bleeding after sexual intercourse can be an infectious lesion - chlamydia and other sexually transmitted diseases. Another symptom of the infectious pathology of the reproductive system is the adherence to the discharge of a foul odor.

Inflammatory lesions
Spotting after and during sex can occur due to inflammatory diseases of the female genital organs. Most often, the release of blood after sex occurs when cervicitis (cervical inflammation) or vaginitis (vaginal inflammation). In both cases, bleeding from the genitals of a woman does not occur only after sex. Sexual intercourse in this situation is only a stimulating factor.

Polyps and cervical erosion
A common cause of bleeding after sex is polyps and cervical erosion. Such secretions, as a rule, are very transient, disappear in just a few hours, but resume again at the very next sexual contact. To get rid of this symptom, it is necessary to consult a gynecologist and undergo treatment of cervical erosion. But the polyps, which can cause further development of malignant tumors, must be removed.

The use of drugs
Bleeding after sexual intercourse may be a consequence of taking certain medications that reduce blood clotting (for example, aspirin) and contraceptives. Taking such drugs is associated with the risk of hypoplasia (thickness reduction) of the uterine lining, which can lead to trauma.

The cause of bleeding can be errors in the intake of contraceptives. Skipping the next dose of these drugs, or using them late, can cause bleeding after sex. In such cases, the gynecologist may advise you to change the drug that caused the adverse reaction, or to temporarily cancel it if the cause of bleeding was errors in its use.

Other pathologies
In rare cases, the cause of bleeding after sex can be in the pathological changes of cervical cells (dysplasia), some blood diseases and uterine cancer. The presence of such pathologies is determined by laboratory analysis of the discharge of the vagina, and other examinations.

Spotting with contraceptive use

Brown spotting in the first two months after the start of hormonal contraceptives is considered a variant of the norm. During the use of medications such as Regulon, Yarin, Jess, bleeding can appear in any phase of the menstrual cycle, which is associated with the suppression of ovulation. After the application of post-coital hormonal contraceptives, such as Postinor, bleeding may also occur due to drastic changes in the body's hormonal balance.

It should be remembered that if the bleeding does not stop at the third and fourth month of permanent use of the drug, the woman should consult a gynecologist. Most likely, this oral contraceptive is simply not suitable for her, and you need to replace him.

What should be the allocation of a healthy woman

Normal indicators of the health of the female reproductive system are full vaginal and uterine discharge. Why they go and regularly come, every qualified gynecologist can explain during the reception.

Mucous membranes of internal organs have their own protective microflora, which provokes the elimination of transparent mucus.

Causes of natural secretions:

  1. microorganisms and epithelial cells of the vagina and uterus,
  2. vaginal lubrication. Observed after intercourse,
  3. protective function of the cervical canal.

There is another type - periodic bloody menstrual flow. Traditionally, bleeding all go differently and have an individual character. Daily amount - from 5-6 grams and up to 15-18 grams of liquid. Duration does not exceed 8 - 9 days. The rest of the menstrual cycle have a creamy or denser consistency of the composition.

After menstruation, for the first 14 days, you can detect whitish or barely visible mucus. The next period is ovulation. Lasts no more than 1-2 days. The volume of mucus increases. Should not have a sharp unpleasant smell and cause discomfort.

Why are spotting going

При возникновении патологических процессов или нарушений в работе женских половых органов, независимо от менструации и совершенно без естественной на то причины, бывают выделения с кровью. Идти они могут неопределенный период времени и невозможно спрогнозировать их прекращение.

Почему появляются кровяные выделения, и какие они бывают:

  1. имплантационные. Observed at conception. At the moment when the fetus is attached to the uterine wall. May last for several days. Small spotting,
  2. improper pregnancy At the beginning of gestation indicates a miscarriage, or ectopic course, in the end - spotting warns of the threat of placental abruption, premature onset of labor,
  3. violation of the flow of the menstrual cycle or the period of ovulation,
  4. contraceptive drugs. Uncontrolled reception leads to bloody clots,
  5. intrauterine device. Irritating to the walls of the uterus.

Other sources also have blood excretions from the vagina.

Which may be gynecological problems and diseases:

  1. endometriosis. Unnatural growth of the inner layer of the uterine wall,
  2. uterine fibroids. Neoplasm of benign character in the muscular layer of an organ,
  3. polycystic ovary syndrome,
  4. cancer of the female reproductive system,
  5. endometritis. The inflammatory process of the mucous membrane of the inner layer of the uterus,
  6. endometrial hyperplasia. Benign growth inside the body of the uterus,
  7. cervicitis. Inflammatory process in the vagina,
  8. infections of the reproductive female organs,
  9. hormonal disorders. Poor blood clotting, increased prolactin, increased sex and thyroid hormones.

If the bleeding does not have a menstrual nature, is not associated with the helix and hormonal drugs, additional examination for the presence of pathologies or inflammatory processes in the uterus and vagina is necessary.

Brown discharge in women from the vagina

The norm for the appearance of smearing brown in vaginal secretions is the period before the intended menstruation or after it. Duration should not exceed 2-3 days. Sometimes you can see these signs in the period of ovulation.

But why are the selection of brown color constantly:

  1. the beginning of sex life
  2. spiral installation
  3. contraceptive use
  4. sexually transmitted diseases,
  5. genital trauma,
  6. tumor tumors
  7. cysts. Have a cavity. Contain liquid inside
  8. changes in the endometrium, the mucous membrane of the inner surface of the uterus.

Long-term stress, nervous disorders, changes in hormonal levels are also causes of violations of natural vaginal secretions.

Discharges during and after pregnancy

During the childbearing and before the onset of childbirth, the woman is under the strict supervision of a qualified gynecologist. If there is any sign of a pregnancy disorder, you should immediately inform your doctor.

The greatest danger to the future mother, as well as her fetus, can be borne by brown or spotting bleeding, which have their own reasons:

  • attachment of the ovum to the body of the uterus. It occurs in the early stages and does not carry any danger for the child. Reason: slight damage to the blood vessels,
  • progesterone deficiency. May cause spontaneous abortion, miscarriage, or premature labor
  • ectopic pregnancy. It is observed when the future baby develops in the fallopian tube, which will lead to its rupture and internal bleeding,
  • frozen fruit. The death of the ovum is accompanied by small smearing clots.

During pregnancy, a brown or blood discharge must be diagnosed and studied. Postpartum hemorrhage should be abundant. Can last 6-8 weeks.

What discharge should be after childbirth:

  1. first 2-3 days. The amount of fluid released is 400 ml per day. Color - scarlet, bloody with mucus, clots,
  2. after 1 week. Blood spotting and brown,
  3. in 5-6 weeks. There is a normalization of secreted fluid, the formation of mucus.

Disorders associated with the appearance of pus, unpleasant smell or pain, fever, should be studied.

Causes of bleeding after sex

With regular bleeding or spotting small clots after intercourse, which are accompanied by pain in the lower abdomen, in the crotch and lumbar region, urgent assistance of a gynecologist is required.

The causes of bleeding after sex can be serious gynecological problems:

  1. vaginitis In women of reproductive age. Caused by bacteria and microorganisms like chlamydia, hemophilus bacillus, staphylococcus,
    cervicitis. Inflammation of the uterus canal,
  2. cervical erosion. Focal lesions of the mucous walls of the body,
  3. damage or ovarian cysts,
  4. ovulation. The release of the egg from the follicle into the fallopian tube for subsequent fertilization,
  5. fungal lesions.

In rare cases, damage to the blood vessels and walls of the vagina provokes a lack of lubrication or the use of orgasm stimulants like dildos.

Discharge after abortion

A surgical termination of pregnancy consists in removing the ovum by curettage or a mini-abortion, vacuum aspiration, in the early stages. After surgical abortion, bleeding continues for up to 10 days. Changes from bright scarlet to brown daubs. With vacuum removal - about 3-5 days.

If the bleeding does not stop after an abortion, the possible consequences are:

  • polyp. Benign neoplasm on the cervix and on the surface of the uterus,
  • endometriosis. Changes in the structure of the inner layer of the uterus wall, its excessive growth beyond the organ,
  • staphylococcus, streptococcus. Bacterial lesion of the genitals.

Additional examination, testing, sampling and treatment prescriptions are required.

Discharge after cauterization of erosion

Ulcerative lesion of the cervical mucosa - a common gynecological disease, resembles a small wound.

Erosion of the cervix is ​​determined by examination by a gynecologist or by characteristic signs, as discharge with blood:

  1. after intercourse,
  2. between menstruation.

The reasons for its occurrence may be congenital pathologies, hormonal disorders, sexually transmitted infections, the consequences of surgery, failure to comply with the rules of intimate hygiene.

Depending on the course and damage of the uterus, treatment is prescribed:

  1. cauterization. There may be a slight discharge of blood after surgery for about 2-3 weeks. After healing, the scab falls off and there is not too much bleeding. The duration of recovery is from 1 to 3 weeks,
  2. freezing or cryosurgery. Conducted using the effects of liquid nitrogen on the lesions. After freezing the erosion for about a month, the patients have heavy discharge with blood.
  3. laser therapy. After 7-10 days after the procedure, there may be slight bleeding.

A method of treatment is selected depending on the woman's age and the gynecological diseases she has, and the degree of tissue damage by erosion.

How many go and what kind of discharge after a miscarriage

Often, spontaneous abortion occurs in early pregnancy, 5-6 weeks, or in the last trimester. The detachment of the ovum begins, the placenta, the cervix opens, the fetus emerges, the vessels are damaged.

As a result, uterine bleeding begins:

  1. 7 days early
  2. 1-2 days after the procedure curettage, curettage.

Be sure to monitor in the hospital after the procedure and examination by a gynecologist. Hemostatic agents and antibiotics are prescribed for treatment, and the cause of spontaneous abortion is being studied.

Discharge with intrauterine device

Do not worry if after installing the intrauterine device appeared bloody discharge. Usually they continue to go about 5 days and will be observed between the menstruation for about six months.

Acute or pulling pain in the lower abdomen and an increase in the amount of blood released is a violation. In this case, urgently required examination and medical consultation.

Why is there a copious discharge with blood after the installation of the spiral:

  • Incorrect procedure. Damage to blood vessels, puncture of the uterus,
  • gynecological diseases,
  • oral contraceptives,
  • ectopic pregnancy,
  • uterine bleeding.

It is impossible to determine the cause independently. Even on examination, the gynecologist will not be able to identify the source of the bleeding.

It is necessary to undergo a complete diagnosis and conduct a series of relevant tests. Perhaps the body does not accept the material from which the spiral is made, and it is rejected.

Menopause discharge

The period that occurs in the life of any mature woman and is characterized by the end of her reproductive function is called menopause. This process is gradual and can last from 1 year or more.

Menstrual discharge becomes small and can be once in 2-4 months until they disappear completely.

If there are frequent heavy bleeding during or after menopause, you need to look for the cause:

  1. hormonal drugs,
  2. bacterial vaginitis. The infection is provoked by bacteria like gardnerella and anaerobic microorganisms,
  3. gonorrhea. Infection by bacteria,
  4. chlamydia A disease that is transmitted through sexual intercourse. The source is chlamydia microorganisms,
  5. trichomoniasis. The causative agent of an infectious disease that is sexually transmitted is the parasite Trichomonas,
  6. endometrial hyperplasia,
  7. neoplasms. A benign tumor, like fibroids, polyp of the body and cervix.

The lack of production of female hormones and protective lubricant leads to sexually transmitted infections and inflammatory processes in women with menopause.

Be sure to be observed by a gynecologist during this period and take hormone preparations.

Pathologies in which unusual whites appear

Spotting between menstruation may indicate a woman has an ectopic pregnancy. This condition is very dangerous. There is a pulling pain in the area of ​​the embryo. With such symptoms in the presence of persistent bleeding, a woman should urgently consult a doctor for surgery to remove the fetus.

The cause of the appearance of pink or brown discharge can also be missed abortion, that is, the death of the fetus in the early stages. Such a pregnancy ends in miscarriage. Its symptoms are pain in the back and lower abdomen. Termination of pregnancy occurs when the woman does not know that she is pregnant, and the symptoms of toxicosis refers to the manifestations of any other ailments. The sudden disappearance of “causeless” nausea and vomiting can also be a sign of such distress.

Unusual spotting as a sign of disease

Blood after menstruation and on other days of the cycle appears as a result of pathologies such as dysfunction of the ovaries and various diseases of the uterus.

Ovarian dysfunction. Occurs due to hormonal disruption in the body, the cause of which may be disruption of the pituitary, thyroid gland, inflammatory and neoplastic diseases of the ovaries, uncontrolled medication, abortion, prolonged stress.

In some cases, the corpus luteum. which is formed in the follicle at the end of ovulation, is inferior. There is a so-called "failure of the second phase of the cycle" as a result of a violation of the production of luteinizing hormone of the pituitary gland. At the same time there is a decrease in progesterone levels. Such a violation appears as an accelerated onset of menstruation, an increase in their duration at the expense of a lightening whiter at the end. This situation can occur once or permanently. It is required to establish the cause of hormonal failure.

Cervical erosion - the formation of ulcers on the surface of its mucous membrane. During sexual intercourse or gynecological examination, as well as during physical stress, the damaged sheath bleeds.

Endometritis - inflammation of the mucous in the uterus. At the same time, not only there is a discharge of blood before and after the menstruation, but also they themselves become long and painful.

Infectious diseases sexually transmitted diseases (gonorrhea, trichomoniasis and others), as well as sexually, and household (for example, thrush). Inflammatory processes in the reproductive organs and disruption of their normal functioning lead to spot bleeding.

Hyperplasia (excessive growth) of the mucous membrane in the uterus. It becomes loose and easily vulnerable. It forms cysts and polyps, the damage of which leads to bleeding, the appearance of blood clots in the bela.

Endometriosis. Abnormal development of the endometrium, when epithelial particles from the uterus penetrate into the adjacent sections. At the same time, in addition to untimely bleeding, the woman has symptoms that it is impossible not to pay attention to: severe abdominal pain several days before menstruation, during their onset and during the next few days.

Uterine myoma submucosa. wherein the tumor nodes grow inside the cavity. The woman periodically appear cramping pain in the uterus and lower back. With fibroids, menstruation is abundant and long (more than 1 week). Then, for a few more days, there is a spotting brown discharge.

Endometrial and cervical cancer. Non-menstrual bleeding may appear at any time throughout the cycle, including at the end of menstruation.

What to do when there are traces of blood in the discharge after menstruation

First of all, you should pay attention to the presence or absence of adverse symptoms: pain in the abdomen and back, cycle disorders. Not only the appearance of unusual post-menstrual discharge, but also an increase in the pain and duration of menstruation should be alerted. The formation of blood clots, the presence of a foul odor, impurities of pus can speak about the disease. frothy or cheesy consistency. The inflammatory and infectious nature of the pathology, its spreading to the urinary organs, is indicated by cutting in the vagina, painful urination.

When signs of trouble appear, one cannot rely on the advice of people who do not have a clue about the features of anatomy and physiology and use any folk remedies without the knowledge of the doctor. The reason for unusual discharge can be very serious, requiring immediate examination. Even in the absence of painful symptoms, doctors recommend to be examined if the discharge with blood appears after menstruation and between them continues for more than 7 days.

Why do women have spotting what they are

Sometimes it is quite difficult to distinguish between the normal natural causes of bleeding and sources caused by diseases and disorders of the female reproductive system, which provoke spotting bleeding. May be bright scarlet and abundant or small light brown. To reveal their origin becomes possible only after an accurate diagnosis and biopsy. Gynecologists also pay attention to the accompanying symptoms, such as obvious itching, burning, pain, redness or allergic edema.

Spotting with menopause

Bleeding during menopause (even the smallest bleeding) is a symptom of illness, and sometimes quite serious, even uterine cancer. Therefore, in no case can you ignore this situation.

Many women are quite difficult to carry menopause. Signs of its pathological course are:

  • strong and frequent tides,
  • metabolic disorders in the body,
  • increase blood pressure
  • the emergence of psychological disorders
  • recurrent bleeding from the genitals.

The common perception that during menopause any symptoms are possible, leads to the fact that many women ignore bleeding, which should not be normal. They occur quite often - according to statistics, more than half of patients over 45 years old refer to a gynecologist because of bleeding during menopause.

Causes and treatment of bleeding during menopause
Symptoms of pathological menopause are primarily due to hormonal alteration of the female body, that is, are dysfunctional. But we must not forget that in some cases, bleeding indicates the presence of benign neoplasms of benign (polyps and fibroids) or malignant nature.

Spotting may occur if a woman uses hormone replacement therapy after menopause. In this case, progesterone therapy may stimulate the recovery of small menstrual bleeding. They can be observed for 1-2 years, usually pass painlessly and easily, lasting no more than 3-4 days. This is the only type of bleeding during menopause, which does not require immediate interruption of the course and treatment. But if a woman takes progesterone, and menstrual bleeding begins at the wrong time, lasts longer than normal, is very abundant, or contains blood clots, then you need to consult a gynecologist.

It is necessary to distinguish between two types of bleeding in menopause:
1. Bleeding in the premenopausal period.
2. Bleeding in the postmenopausal period.

Premenopausal bleeding
Bleeding in the premenopausal period is usually caused by a violation of the production of sex hormones in women aged 45-50 years, until the complete cessation of menstruation. Their cause is a violation of ovulation terms, which lead to a failure of cyclic changes in the thickness of the uterine mucosa.

Usually, menopausal menstruation bleeding occurs after a delayed menstruation, and sometimes it starts on the day of the expected menstruation, or even a little earlier. Such bleeding may have a different intensity, and be observed for several weeks, or even months. They are characterized by relapses, sometimes occurring within 4-5 years.

Especially often the bleeding during menopause occurs in women suffering from metabolic disorders and various endocrine diseases. Therefore, the appearance of the first signs of climacteric bleeding is a reason for compulsory examination in order to identify violations of the functions of the thyroid and pancreas, liver, fat and carbohydrate metabolism.

Postmenopausal bleeding
Any bleeding in the postmenopausal period, that is, after complete cessation of menstruation, should always be considered as a threatening symptom. Such bleeding is a sign of tumors, including malignant nature. In such cases, diagnostic curettage is almost always carried out, affecting the mucous membrane of the uterus body and its cervical canal, as well as subsequent histological examination of the scraping.

What kind of doctor to contact with bleeding from the genital tract?

Despite the fact that bleeding from the vagina can be evidence not only of diseases of the female genital tract, but also a symptom of a coagulation disorder, it is necessary to contact a gynecologist when they occur, since coagulopathy (coagulation disorders) is much less common than gynecological pathology . So, the doctor examines a woman and, if necessary, will refer to hematologist (to sign up).

In addition, every woman and girl should know that the release of blood from the genital tract in some cases is a sign of an emergency, the essence of which is that some kind of catastrophe occurs in the body and immediate medical care is required to save lives. If signs of such a dangerous condition appear, you should immediately call an Ambulance and be hospitalized in the hospital so that the doctors can provide the help you need to save life.

So, it is urgent to call an ambulance and be hospitalized in the hospital if during or after intercourse in the abdomen or in the vagina there is severe pain and begins heavy bleeding. In this situation, urgent help is needed due to the fact that organs have been injured during sexual intercourse and that gaps and traumatic injuries need to be closed so that the woman does not die from blood loss.

In addition, it is necessary to call an ambulance and hospitalize pregnant women for any period of gestation when they have bloody discharge from the vagina. Any discharge of blood from the vagina during pregnancy should be considered as dangerous. Although theoretically bloody discharge from the vagina during pregnancy may be non-dangerous, due, for example, to cervical erosion, but it is difficult to distinguish them from dangerous ones. Moreover, at the beginning of the bleeding may have signs of non-hazardous, but this is deceptive, because at any moment they can increase, take their true character and become very dangerous (for example, during ectopic pregnancy, miscarriage, placental abruption, etc.) .

In addition, bloody vaginal discharge in women and girls of any age should be considered dangerous if they increase or do not decrease with time, possibly combined with severe lower abdominal pain (right, left, in the middle or everywhere) or lower back, high body temperature, severe and rapid deterioration of well-being after the onset of bleeding, pallor, pressure decrease, palpitations, profuse sweating, possibly fainting. Remember that with a dangerous discharge of blood from the vagina, the woman’s condition quickly and dramatically deteriorates so that she literally can not stand and sit, and almost faints.

Treatment of bleeding from the genitals in women of any age has several goals:
1. As soon as possible to stop heavy bleeding and replace blood loss.
2. Elimination of the cause that caused the bleeding.
3. Compensation for the consequences of blood loss (for example, anemia).

Examination for bleeding
Before you prescribe treatment, the gynecologist conducts an examination to determine the true cause of bleeding.

The survey program, as a rule, includes:

  • a detailed survey of the patient, on the basis of which the doctor makes conclusions about her psychological state, hereditary diseases in the family, etc.,
  • visual inspection of the vagina with the help of mirrors,
  • laboratory examination of vaginal smears,
  • examination of cervical tissue using colposcopy or biopsy,
  • ultrasound examination of the pelvic organs,
  • in certain cases - diagnostic curettage of the uterine cavity, followed by microscopic examination of endometrial tissues,
  • determination of hormone levels
  • general blood analysis.

What tests and examinations can be prescribed by a doctor for bloody vaginal discharge?

Bloody discharge from the vagina can be provoked by various diseases and conditions, for the diagnosis of which different methods are used. The choice of a diagnostic method in each specific case of the discharge of blood from the vagina is made by the doctor individually, depending on the accompanying symptoms, due to which the disease that caused the bleeding or hemorrhage can be presumed. Below we consider what tests and examinations the doctor may prescribe for bleeding from the vagina with various associated symptoms, and touch only on those situations when you do not need to urgently call an ambulance.

Dark bloody vaginal discharge (brown, brownish, maroon, dark red, etc.) in large or small quantities, appearing outside of menstruation or before menstruation, cause the doctor to suspect a pathological process in the uterus (for example, endometrial polyps or cervical canal, endometrial hyperplasia, endometriosis, etc.). In such a situation, the doctor prescribes the following tests and examinations:

  • Bimanual gynecological examination,
  • Inspection of the genital tract in the mirrors,
  • Vaginal swab on the flora (sign up),
  • Hysteroscopy (enroll),
  • Ultrasound of the pelvic organs (to sign up),
  • Separate diagnostic curettage (enroll),
  • Magnetic resonance imaging (enroll),
  • General blood analysis,
  • General urine analysis,
  • Blood chemistry,
  • Coagulogram (to enroll),
  • Blood test for luteinizing hormone,
  • Blood test for follicle-stimulating hormone,
  • Blood test for testosterone.

First of all, a bimanual two-handed examination and examination of the genital tract in mirrors is always carried out. A smear is also taken on the flora, ultrasound of the pelvic organs is prescribed, since it is these examination methods that allow you to diagnose the disease or narrow the diagnostic search. To assess the general condition of the body, general blood and urine tests, a biochemical blood test and a coagulogram (assessment of the blood coagulation system) are also prescribed. Further, if according to the results of ultrasound and examination a disease is detected (for example, cervical polyp, uterine fibroids, endometriosis, etc.), the doctor prescribes hysteroscopy or magnetic resonance imaging to clarify data on the localization of the pathological focus and assess the condition of the tissues. If the results of the ultrasound revealed endometrial hyperplasia, the doctor prescribes separate diagnostic curettage. If the examination revealed endometriosis, then the doctor may also prescribe blood tests to determine the concentration of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone in the woman.

If the examinations did not reveal any diseases, and there are bleeding, the doctor prescribes tests for genital infections (chlamydia (enroll), mycoplasmosis (to enroll), ureaplasmosis (to sign up), trichomoniasis, candidiasis, gardnerellosis, gonorrhea (enroll), syphilis (enroll)).

If a woman systematically has spotting bleeding that emits an unpleasant or offensive odor, and they can occur on any day of the menstrual cycle, the doctor suspects infectious-inflammatory process in the genitals and prescribes tests for genital infections (chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, and candidiasis , gardnerellez, gonorrhea, syphilis), as well as ultrasound of the pelvic organs. For analysis of genital infections (to sign up) You can donate blood, discharge of the vagina and urethra. As a rule, the doctor recommends the woman what tests she needs, and what should be passed for biological material.

If periodically before the monthly appear pinkish discharge, resembling diluted blood and emitting an unpleasant smell, endometritis or endocervicitis is suspected. In this case, the doctor prescribes the following tests and examinations:

  • Gynecological examination (book),
  • General blood analysis,
  • Smear on flora,
  • Bacteriological seeding of detachable vagina,
  • Ultrasound of the pelvic organs,
  • Hysteroscopy
  • Separate diagnostic curettage with histological examination of the material,
  • Extended colposcopy (enroll),
  • Cervical cytology smear (enroll),
  • Bacteriological smear from the cervical canal,
  • Blood tests or vaginal discharge for genital infections (chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, candidiasis, gardnerellez, gonorrhea, syphilis) using ELISA methods, PCR (enroll) and etc.,
  • Biopsy of the cervix.

First of all, the doctor performs a gynecological examination, prescribes a complete blood count, smear on the flora, seeding of the vaginal discharge and ultrasound of the pelvic organs, since these examinations allow us to understand whether a woman suffers from endocervicitis or endometritis. Further, other examinations are appointed in order to clarify the parameters of the pathological process and determine the causes of the disease. So, when the identified endometritis is a separate diagnostic curettage with or without hysteroscopy. Hysteroscopy allows you to see the endometrium inside the uterus and assess its condition, and curettage allows you to only get the result of its histology and understand whether there is only inflammation, or whether it is a question of precancerous conditions or even cancer. From the point of view of alertness for cancer, doctors prefer to perform curettage followed by a histological examination of the material, and hysteroscopy is carried out only in some cases.

If endocervicitis was detected, then, first of all, an extended colposcopy is prescribed and performed and a smear is taken on cytology in order to reveal whether there is a cancerous cell degeneration. Next, a blood test or a vaginal discharge for sexually transmitted infections and bacteriological seeding of a smear from the cervical canal is prescribed to determine the microbe that has become the causative agent of the infectious process. If, according to the results of cytology, the presence of tumor cells is detected, then biopsy (enroll) cervix for early detection of cancer.

Scanty and spotting of any nature (pink, red, brownish, etc.) in various parts of the menstrual cycle (in the middle, before menstruation, after menstruation) make menstrual disorders, endometriosis, polyps, endometritis, fibroids, genital infections suspect. , genital trauma, cervical erosion, cervical cancer. In such a situation, the doctor first of all prescribes a gynecological examination, examination in mirrors, a smear on the flora and ultrasound of the pelvic organs, as these simple examinations reveal a number of additional signs that can be used to fairly accurately diagnose the existing disease and further other additional studies for confirmation of diagnostic guess.

So, if, as a result of the inspection, damage to the genital organs is revealed, the doctor removes it - sucks in the gaps, removes foreign objects, treats the mucosa with an antiseptic, etc. In such a situation, other examinations are not appointed, as they are not needed. If, during examination and ultrasound, erosion or an incomprehensible formation on the cervix was detected, the doctor prescribes a colposcopy, a smear for cytology, or immediately take a biopsy of the affected area to understand whether there is erosion or whether it is a precancer or cancer.

If the results of ultrasound revealed endometriosis, tomography is prescribed to clarify the localization of ectopic foci and blood tests for hormones - testosterone, luteinizing and follicle-stimulating. If the examination and ultrasound reveal polyps or a tumor (myoma, etc.), additional hysteroscopy is prescribed. If the examination and ultrasound revealed endometritis, a separate diagnostic curettage is additionally prescribed. If ultrasound and examination revealed signs of genital infections, then a blood test or vaginal discharge on pathogens of inflammation (chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, candidiasis, gardnerellez, gonorrhea, syphilis) is prescribed. And when the results of the ultrasound and examination revealed no pathology, the doctor prescribes blood test for thyroid hormones (to sign up), as in such a situation, most likely, poor bleeding due to the violation of the work of this particular body.

When a woman has large blood clots during menstruation, this suggests a cervical curvature, a pathology of blood clotting, a deficiency of B vitamins, endometriosis or tumors in the uterus (polyps, fibroids). In such a situation, the doctor, first of all, performs a gynecological examination and examination in the mirrors, prescribes ultrasound of the pelvic organs, complete blood count, coagulogram (APTTV, PET, TV, fibrinogen, clot retraction, etc.). If the pathology results in a coagulogram, a woman is referred to a hematologist. If by results Ultrasound (enroll) and examination revealed cervical bend - prescribe therapy. If ultrasound and examination revealed endometriosis, tomography of blood tests for hormones is prescribed - testosterone, luteinizing and follicle-stimulating. If ultrasound and examination revealed polyps or myomas, hysteroscopy is prescribed.

If a girl or woman develop heavy and prolonged dysfunctional bleeding before or after her period, hormonal imbalance is suspected, in which case the doctor prescribes the following tests to understand why the ovaries are not functioning normally and do not produce the necessary amount of hormones to maintain the correct menstrual cycle:

  • Blood test for the level of thyroid stimulating hormone (TSH, thyrotropin),
  • Blood test for triiodothyronine (T3) level,
  • Blood test for thyroxin level (T4),
  • A blood test for follicle-stimulating hormone (FSH) levels,
  • A blood test for luteinizing hormone (LH) levels,
  • Blood test for prolactin level (to sign up),
  • Blood test for estradiol,
  • Blood test for testosterone levels.

If a woman has bleeding after intercourse, then an STI, cervicitis, vaginitis, polyps and cervical erosion are suspected, and in this case the doctor will prescribe, first of all, examination in mirrors, bimanual examination, smear-taking flora, smear-taking cervix cytology and ultrasound of the pelvic organs. Further assignments are based on data from these primary surveys. So, if as a result of the examination revealed erosion of the cervix, then a colposcopy is prescribed and carried out. If polyps are detected, they are treated (they are removed). If cervicitis was detected, a colposcopy was also performed and tests for sexually transmitted infections were performed in order to understand which pathogen triggered the inflammatory process. If the results of the examination and smear on the flora revealed an inflammatory process, then STI tests are also prescribed. After the result of a smear on cytology from the cervix comes, the doctor decides whether to take a biopsy. So, if cytology did not reveal atypical (tumor) cells, they do not take a biopsy, but if they are found, then a cervical biopsy is prescribed to understand whether there is a malignant tumor or whether atypical cells are a random finding.

If, after an abortion in a woman, there is abundant uterine bleeding, the doctor, in the first place, performs an ultrasound scan to verify that there is no residue in the uterus. If they are found, scraping is carried out. If they are not found, a coagulogram is prescribed, and the woman is sent to a hematologist, since the bleeding is considered to be due to coagulation pathology.

Если обильное кровотечение развивается у женщины в менопаузе, то обязательно назначается раздельное диагностическое выскабливание с гистологическим исследованием материала, так как подобная ситуация часто является признаком опухолей или предраковых фоновых заболеваний.

If bleeding occurs in a girl under 12 years old, the doctor prescribes a full range of diagnostic procedures - pelvic ultrasound, sexually transmitted infection tests, hormone tests (cortisol, triiodothyronine, thyroxin, follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, testosterone). In addition, a general urinalysis is prescribed to exclude kidney disease and a biochemical blood test and Ultrasound of the abdominal organs (to sign up).

Treatment of bleeding

Conservative methods:
1. Most often, the basis of the therapeutic program is hormone therapy. Such treatment courses are usually prescribed for up to 3 months. After its termination, a break in treatment is made, during which the gynecologist evaluates its results.
2. In addition to hormonal drugs, symptomatic treatment is also used - hemostatic drugs and drugs that enhance uterine contractile activity.
3. Restorative therapy that helps the recovery of the female body as a whole.
4. Also, experts recommend to avoid physical and psychological stressful situations.

Selection of the optimal treatment regimen for bleeding occurs individually. It should also be remembered that the treatment will last from 3-4 weeks to six months or more, depending on the cause of the violation. In order to restore the normal functioning of the female reproductive system, it may take several months.

Operational methods
Surgical bleeding is also used to treat severe bleeding. For example, in patients who are menopausal, curettage of the uterus is the main diagnostic method. And for juvenile bleeding in adolescent girls, such a procedure is carried out solely for health reasons. After the application of operative methods, treatment aimed at preventing the recurrence of discharge is prescribed.


Treatment of bleeding from the genital tract should be carried out only by a gynecologist. Self-treatment is absolutely unacceptable, even if the woman is confident that she knows the true cause of the bleeding. Misdiagnosis and inadequate treatment of genital bleeding can lead to serious complications.

Recently, asymptomatic gynecological diseases, including neoplastic, are increasingly common. Even pathological vaginal discharge is not always observed. Without laboratory tests and professional examination to diagnose such diseases is impossible. Therefore, every woman should undergo a routine examination by a gynecologist at least every six months.